| Entity Name: | JHEZANUEL GONCALVES, D.M.D. P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 10 Nov 2021 (3 years ago) |
| Document Number: | P21000096575 |
| FEI/EIN Number | 87-3822466 |
| Address: | 2863 EXECUTIVE PARK DRIVE, SUITE 101, WESTON, FL, 33331, US |
| Mail Address: | 2863 EXECUTIVE PARK DRIVE, SUITE 101, WESTON, FL, 33331, US |
| ZIP code: | 33331 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851042311 | 2022-01-15 | 2022-05-06 | 2863 EXECUTIVE PARK DR STE 101, WESTON, FL, 333313647, US | 2863 EXECUTIVE PARK DR STE 101, WESTON, FL, 333313647, US | |||||||||||||||
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| Phone | +1 954-660-1091 |
| Fax | 9546691084 |
Authorized person
| Name | DR. JHEZANUEL GONCALVES CORDERO |
| Role | PRESIDENT |
| Phone | 9546691091 |
Taxonomy
| Taxonomy Code | 1223G0001X - General Practice Dentistry |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GONCALVES JHEZANUEL | Agent | 2863 EXECUTIVE PARK DRIVE, WESTON, FL, 33331 |
| Name | Role | Address |
|---|---|---|
| GONCALVES CORDERO JHEZANUEL C | President | 2863 EXECUTIVE PARK DRIVE, STE. 105, WESTON, FL, 33331 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000158691 | THE BLANC SMILE | ACTIVE | 2021-11-30 | 2026-12-31 | No data | 2863 EXECUTIVE PARK DRIVE SUITE 101, WESTON, FL, 33331 |
| G21000154575 | LE BLANC DENTAL SPA | ACTIVE | 2021-11-18 | 2026-12-31 | No data | 2863 EXECUTIVE PARK DRIVE, SUITE 105, WESTON, FL, 33331 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-25 | 2863 EXECUTIVE PARK DRIVE, SUITE 101, WESTON, FL 33331 | No data |
| CHANGE OF MAILING ADDRESS | 2022-04-25 | 2863 EXECUTIVE PARK DRIVE, SUITE 101, WESTON, FL 33331 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-04 |
| ANNUAL REPORT | 2023-04-29 |
| ANNUAL REPORT | 2022-02-19 |
| Domestic Profit | 2021-11-10 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
